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Fill and Sign the Rental Agreements for Camper Form

Fill and Sign the Rental Agreements for Camper Form

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VISA APPLICATION EMBASSY OF VIETNAM (FOR NON-VIETNAMESE PASSPORT HOLDERS) ______ 1233 20th Street, NW, Suite 400 Washington, D.C. 20036 01 Photo (2’x 2’) Tel: (202) 861-0694 & (202) 861-2293 Fax: (202) 861-1297 http://www.vietnamembassy-usa.org 1. Name (in block letters): .................................................................................…………………………………………. First name 2. Date of birth:..................................….………… dd mm yy Female 3. Male: 4. Place of birth:....................................................... 5. Nationality at birth:.............................................. Nationality at present:........................................... 6. Passport number:.................................................. Date of issue:...................Date of expiry:...........… 7. Profession:............................................................. Place of employment:........................................... Telephone (Office):…....…..................................... 8. Present address: (P.O Box Not Accepted) ………….………………………………………….…. ………………………………………………………... Telephone (Home):............................................…. 9. Accompanying children included in your same passport (full name, date of birth, gender): ……………………………………………………….. ................................................................................... …...................…..................................................…… Family name Middle name 10. Purpose of visit to Vietnam: ................................................................................. Tourist ................................................………………… 11. Name, address of your contact in Vietnam: (organization or individual) ................................................…………………… ................................................................………... ................................................................................ ………………………………………….……….. 12. Proposed date of entry and exit Vietnam: from................................to....…..….….……... dd mm yy dd mm yy 13. Number of entries: Single Multiple 14. Port of arrival and departure: All international ports of entry in Vietnam. I solemnly declare that the statements made in this application are true and correct. Place:……………………………………………………………….. Date:………………………………………………………………… Signature: ....................................................................................…. Before submitting, make sure you have included: Original Passport; Completed Application with One Photo Attached; Visa Fee: Money Order (or Cashier’s Check); and Self-addressed Pre-paid FedEx Slip, (for mailing back issued visas).

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